From Phenylthiazoles to Phenylpyrazoles: Broadening the

Subscriber access provided by EKU Libraries

Article

From Phenylthiazoles to Phenylpyrazoles: Broadening the Antibacterial Spectrum towards Carbapenem-Resistant Bacteria Ali Hammad, Nader S. Abutaleb, Mohamed Elsebaei, Allison B Norvil, Mohamed Alswah, Alsagher O. Ali, Jelan A. Abdel-Aleem, Abdulaziz Alattar, Samar Bayoumi, Humaira Gowher, Mohamed N. Seleem, and Abdelrahman S Mayhoub J. Med. Chem., Just Accepted Manuscript • DOI: 10.1021/acs.jmedchem.9b00720 • Publication Date (Web): 01 Aug 2019 Downloaded from pubs.acs.org on August 3, 2019

Just Accepted “Just Accepted” manuscripts have been peer-reviewed and accepted for publication. They are posted online prior to technical editing, formatting for publication and author proofing. The American Chemical Society provides “Just Accepted” as a service to the research community to expedite the dissemination of scientific material as soon as possible after acceptance. “Just Accepted” manuscripts appear in full in PDF format accompanied by an HTML abstract. “Just Accepted” manuscripts have been fully peer reviewed, but should not be considered the official version of record. They are citable by the Digital Object Identifier (DOI®). “Just Accepted” is an optional service offered to authors. Therefore, the “Just Accepted” Web site may not include all articles that will be published in the journal. After a manuscript is technically edited and formatted, it will be removed from the “Just Accepted” Web site and published as an ASAP article. Note that technical editing may introduce minor changes to the manuscript text and/or graphics which could affect content, and all legal disclaimers and ethical guidelines that apply to the journal pertain. ACS cannot be held responsible for errors or consequences arising from the use of information contained in these “Just Accepted” manuscripts.

is published by the American Chemical Society. 1155 Sixteenth Street N.W., Washington, DC 20036 Published by American Chemical Society. Copyright © American Chemical Society. However, no copyright claim is made to original U.S. Government works, or works produced by employees of any Commonwealth realm Crown government in the course of their duties.

Page 1 of 49 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60

Journal of Medicinal Chemistry

From Phenylthiazoles to Phenylpyrazoles: Broadening the Antibacterial Spectrum towards Carbapenem-Resistant Bacteria

Ali Hammada⊥, Nader S. Abutalebb⊥, Mohamed M. Elsebaeia, Allison B. Norvilc, Mohamed Alswaha, Alsagher O. Alib,d, Jelan A. Abdel-Aleemb,e, Abdelaziz Alattarf, Samar A. Bayoumig, Humaira Gowherc,h, Mohamed N. Seleemb,i**, and Abdelrahman S. Mayhouba,j* a.

Department of Pharmaceutical Organic Chemistry, College of Pharmacy, Al-Azhar University, Cairo 11884, Egypt b. Department of Comparative Pathobiology, Purdue University, College of Veterinary Medicine, West Lafayette, IN 47907, USA c. Department of Biochemistry, College of Agriculture, Purdue University, West Lafayette, IN 47907, USA d. Division of infectious Diseases, Animal Medicine Department, Faculty of Veterinary Medicine, South Valley University, Qena, 83523, Egypt e. Department of Industrial Pharmacy, Faculty of Pharmacy, Assiut University, Assiut, 71515, Egypt f. Department of Analytical Chemistry, College of Pharmacy, Al-Azhar University, Cairo 11884, Egypt. g. Department of Pharmaceutics, College of Pharmacy, Heliopolis University, Cairo, 11777, Egypt h. Purdue University Center for Cancer Research, Purdue University, West Lafayette, IN 47907, USA i. Purdue Institute for Inflammation, Immunology, and Infectious Diseases, West Lafayette, IN 47907, USA j. University of Science and Technology, Nanoscience Program, Zewail City of Science and Technology, October Gardens, 6th of October, Giza 12578, Egypt

ACS Paragon Plus Environment

Journal of Medicinal Chemistry 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60

ABSTRACT

The narrow antibacterial spectrum of phenylthiazole antibiotics was expanded by replacing the central thiazole with a pyrazole ring while maintaining its other pharmacophoric features. The most promising derivative, compound 23, was more potent than vancomycin against MDR-Grampositive clinical isolates, including vancomycin- and linezolid-resistant MRSA, with a minimum inhibitory concentration (MIC) value as low as 0.5 g/mL. Moreover, compound 23 was superior to imipenem and meropenem against highly pathogenic carbapenem-resistant strains, such as Acinetobacter baumannii, Klebsiella pneumoniae and E. coli. In addition to the notable biofilm inhibition activity, compound 23 outperformed both vancomycin and kanamycin in reducing the intracellular burden of both Gram-positive and Gram-negative pathogenic bacteria. Compound 23 cleared 90% of intracellular MRSA and 98% of Salmonella enteritidis at 2× the MIC. Moreover, preliminary pharmacokinetic investigations indicated that this class of novel antibacterial compounds is highly metabolically stable with a biological half-life of 10.5 hours suggesting a once-daily dosing regimen. Key words. Broad spectrum, MRSA, VRE, carbapenem-resistant enterobacteriaceae (CRE), New Delhi metallo-beta-lactamase (NDM), Klebsiella pneumoniae carbapenemase (KPC)


Page 2 of 49

Page 3 of 49 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60


INTRODUCTION According to a report released from the World of Health Organization (WHO) in September 2017, the world is running out of antibiotics1 for both Gram-positive and Gram-negative bacteria. The list of the most critical priority pathogens for antibiotic development is dominated by Gramnegative bacteria.1 Gram-negative pathogens are characterized by an impassable outer membrane that prevents most of the chemical compounds, leaving porin channels as the only gate for the antibacterial agents to cross through.2 As porins are lined with highly charged residues such as aspartate, glutamate and arginine,3 the physicochemical properties of antibacterial compounds are a crucial factor that medicinal chemists have to consider. In general, drugs targeting Gram-negative pathogens are more polar compared to others having limited anti-Gram-negative activity.4 This work built on the discovery of a lead compound, phenylthiazole, which bears an alkyl side chain on one side and a guanidine head on the other side; it possesses antimicrobial activity against Gram-positive pathogens.5 This initial discovery was followed by intensive structural optimization to improve its antimicrobial activity and metabolic stability.6-15 The structural optimization focused on the nitrogenous part, the lipophilic tail and the connection with the phenylthiazole scaffold.6-15 Our structural optimization efforts with 1st generation compounds using different heterorings as a linker between the guanidine head and the main scaffold overcame its metabolic instability and improved its antibacterial activity (Figure 1).6, 9, 13, 15 Using an alkynyl lipophilic moiety blocked the metabolic soft spot,14 increased biological half-life and enhanced the systemic efficiency.8 Although the synthesized phenylthiazoles had several advantages, such as being able to clear intracellular pathogens, penetrate and reduce the burden of bacterial biofilm and induce fast lethal mode of action, they exhibited a narrow spectrum of activity in that they inhibit Gram-



positive pathogens only (Table 1S). Since recent mechanistic studies suggested that phenylthiazoles exert their antibacterial effect via the suppression of two vital proteins involved in bacterial cell wall synthesis, which undecaprenyl pyrophosphate phosphatase (UppP) and undecaprenyl pyrophosphate synthase (UppS),8, 12 that are essential in both Gram-positive and Gram-negative bacterial strains, we hypothesized that the observed narrow spectrum of activity can be related to the poor permeability of the compounds into Gram-negative pathogens.

Figure 1. Summary of the developmental progress of phenylthiazoles antibiotics and the objective of the current study. The overall objective of this study is to design compounds capable of targeting Gramnegative pathogens. Since the structure-activity relationships (SAR) of our phenylthiazoles established that both the guanidine structure (colored red in Figure 1) and lipophilic part (colored blue in Figure 1) are essential for the antimicrobial activity, we turned our attention to the central thiazole ring and replaced it with a more polar azole moiety; i.e., pyrazole ring (Figure 1). This structural modification would keep the essential structural elements in their positions while


Page 4 of 49

Page 5 of 49 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60


decreasing the lipophilicity by a factor of 25%, as measured by logP values, (Figure 1). This includes the design and synthesis of phenylpyrazoles bearing the most promising side chains, in terms of pharmacodynamic and pharmacokinetic properties; i.e., the alkynyl derivatives, and investigating their microbiological profiles versus a large panel of highly and extremely drugresistant Gram-positive and Gram-negative clinical isolates. Additionally, the suitability of the most promising compounds for systemic administration was studied via addressing the key pharmacokinetic parameters. RESULTS AND DISCUSSIONS Chemistry. The reaction of 3-[(dimethylamino)methylene]pentane-2,4-dione (1), in situ generated from acetylacetone and dimethylformamide-dimethylacetal (DMF-DMA), with p-iodophenylhydrazine (2), afforded the starting building block N-phenylpyrazole 3 (Scheme 1). The latter key starting material was then allowed to react with terminal acetylene synthons, under standard Sonogahira conditions, to yield compounds 4-15. Finally, condensation of acetyl-containing intermediates 415 with aminoguanidine or its cyclic 2-hydrazinylimidazole salts provided the final products 1638 (Scheme 1).



Scheme 1 O O

O

NHNH2

N N

a

+

O N N

b

N I 1

2

I R

3

4-15

d N N

c HN

NH

N

NH

NH2 NH

N N

N N

28-39

16-27 R

R R

R

R

8, 20, 32

12, 24, 36

9, 21, 33

13, 25, 37

4

10, 22, 34

14, 26, 38

5

11, 23, 35

15, 27, 39

4, 16, 28 2

5, 17, 29

3

HO

6, 18, 30 7, 19, 31

OH

N

Reagents and conditions: (a) Absolute EtOH, heat to reflux, 12 h, (b) proper terminal acetylene, PdCl2(PPh3)2 (5% mol), CuI (7.5% mol), Et3N, DME, heat at 65°C for 16 h; (c) aminoguanidine HCl, EtOH, Conc. HCl, heat to reflux 12 h; (d) 2-hydrazinyl-4,5-dihydro-1Himidazole HBr, EtOH, conc. HCl, heat to reflux 16 h.


Page 6 of 49

Page 7 of 49 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60


Biological Results and Discussion The highly contagious MRSA USA300 clinical isolate was chosen for initial evaluation of activity against Gram-positive bacteria. The TolC mutant E. coli (ΔtolC, encoding for efflux pump) was selected for the initial anti-Gram-negative activity. Linear acetylenes (compounds 16-19) provided an almost flat SAR with narrow difference between the pentyl 16 (MIC value of 4 g/mL) and other longer derivatives, such as compounds 17-19 (MIC value of 2 g/mL), against MRSA USA300 (Table 1). On the other hand, the activity of the phenylpyrazole with a longer side chain (compound 19) was one-fold less potent than other analogs against TolC mutant E. coli. To explore the effect of cyclic side chains on the antibacterial activity, we started with the cyclopropylacetylenyl derivative 20, which was one-fold less potent than the corresponding openchain with the same number of carbon units (compound 16). Expanding the size of the terminal alicyclic moiety by replacing the cyclopropyl group with a cyclopentyl group yielded compound 23, an equi-potent compound to vancomycin, with a MIC value of 1 g/mL against MRSA USA300. Parallel to the improvement in its antistaphyloccal activity, the anti-Gram-negative potency was also ameliorated. In this regard, the MIC value of compound 23 against E. coli (TolC mutant strain) was two-times lower than the corresponding opened-chain analog (compound 4). Further expanding the ring size produced the cyclohexyl compound 21 and its aromatized analog 22 with almost similar antibacterial activities on both MRSA USA300 and E. coli. Moving from the cyclic to branched side chains was associated with four to eight-fold drop in antibacterial activity as observed with compound 24 (Table 1). Further branching, as in the case of compound 27, nullified the antibacterial activities against both tested microorganisms. The attempt to reduce the lipophilicity of the terminal side chain by introducing a polar hydroxyl group ended up with variable impact as the



Page 8 of 49

hydroxycyclohexyl derivative 26 maintained the antibacterial effect, observed with the cyclohexyl 21, on both tested species. On the other hand, the replacement of one methyl group from compound 24 with a hydroxyl led to an inactive compound 25 (Table 1). Finally, the aminoimidazoline analogs 28-39 showed close SAR. Table 1. Minimum inhibitory concentration (MIC in µg/mL) of compounds initially screened against methicillin-resistant Staphylococcus aureus (MRSAUSA300) and TolC mutant Escherichia coli Compounds/ Control drugs

Staphylococcus aureus NRS 384 (MRSA USA300)

Escherichia coli JW55031 (TolC mutant strain)

16

4

4

17

2

4

18

2

4

19

2

8

20

8

8

21

2

2

22

1

2

23

1

2

24

8

8

25

128

128

26

2

4

27

128

128

28

8

16

29

2

4

30

2

2

31

4

8

32

16

32

33

4

4

34

4

4

35

4

4

36

16

16

37

32

16

38

64

32

39

> 128

> 128

1 NT

NT 0.5

Vancomycin Gentamycin


Page 9 of 49 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60


Table 2. Antimicrobial activity of phenylpyrazoles (MICs, in µg/mL) against clinically relevant drug-resistant staphylococcal clinical isolates. Bacterial Strains Compounds/ Control antibiotics 16 18 21 22 23 26 30 35 Lin van Staphylococcus 2 2 2 1 0.5 2 2 1 1 1 aureus ATCC 6538

Staphylococcus aureus NRS107

4

2

2

2

1

4

4

2

1

2

Linezolid-resistant MRSA NRS119

2

2

2

1

1

2

2

4

32

1

MRSA NRS123 (USA400)

2

2

2

2

2

2

4

4

1

1


4

2

2

1

1

2

2

4

1

1


2

2

2

1

0.5

2

2

4

2

1


4

2

2

2

1

2

2

4

2

1

VRSA10

2

2

2

1

0.5

2

2

8

1

>64

VRSA12

2

2

2

2

1

2

2

4

1

64

VRSA: vancomycin-resistant staphylococcus aureus Lin: Linezolid Van.: Vancomycin

Next, the spectrum of the antibacterial activity of eight selected compounds (16, 18, 21, 22, 23, 26, 30, and 35) was examined against a large panel of clinically relevant Gram-positive and Gram-negative bacterial pathogens. Starting with multidrug resistant (MDR)-staphylococcal isolates that continue to be a source of healthcare-associated infections, including bloodstream infections, osteomyelitis, sepsis and necrotizing pneumonia.16, 17 In the United States alone, nearly half of the fatalities caused by drug resistant pathogens are attributed to methicillin-resistant Staphylococcus aureus (MRSA).18 In addition, it has been reported that some clinical isolates of MRSA that are resistant to nearly all antibiotic classes, such as the β-lactams, fluoroquinolones,



Page 10 of 49

macrolides, tetracyclines, and lincosamides, had been isolated.19,

20

The problem was further

exacerbated by the emergence of clinical isolates exhibiting resistance to the the last resort antibiotics such as vancomycin and linezolid.21, 22 We tested eight selected compounds (16, 18, 21, 22, 23, 26, 30, and 35) against methicillin-sensitive S. aureus (MSSA), methicillin-resistant S. aureus (MRSA USA300, USA400, USA500 and USA700), vancomycin-resistant S. aureus (VRSA) and linezolid-resistant MRSA. Remarkably, all the tested phenylpyrazoles exhibited potent antibacterial activity against all tested staphylococcal strains inhibiting their growth at concentrations mostly ranging between 1 to 2 µg/mL (Table 2). In particular, compound 22 was as effective as vancomycin and linezolid, the drugs of choice for treatment of staphylococcal infections). Moreover, the cyclopentyl 23 was superior to vancomycin and linezolid against MRSA USA500 (Table 2), the highly contagious community-acquired strain.23 The MBC values for the compounds were found to be equal to or up to two-fold higher than the compounds’ MIC values against the tested bacterial strains indicating the compounds are bactericidal (Table 2S). The compounds’ bactericidal mode of action was then confirmed by a standard time-kill assay (Figure 1S). Table 3: Antimicrobial activity of phenylpyrazoles (MICs, in µg/mL) against other clinically important Gram-positive bacterial pathogens Bacterial Strains Staphylococcus epidermidis NRS 101 Enterococcus faecalis ATCC 51299 (VRE)1 Enterococcus faecium ATCC 700221 (VRE) Listeria monocytogenes ATCC 19111

Compounds/ Control antibiotics 22 23 26 30 35 2 1 4 2 2

16 4

18 2

21 2

4

2

2

1

0.5

2

4

4

2

1

1

1

2

4

2

2

2

0.5

2


Lin ≤0.5

Van 1

8

1

32

2

4

1

>64

2

4

1

2

Page 11 of 49 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60


Bacterial Strains 16

18

21

Compounds/ Control antibiotics 22 23 26 30 35 1 1 4 4 8

Cephalosporin4 2 2 resistant Streptococcus pneumoniae ATCC 51916 Methicillin-resistant 4 2 2 2 Streptococcus pneumoniae ATCC 700677 Clostridium difficile 8 4 4 4 ATCC BAA 1870 1VRE: vancomycin-resistant Enterococci; 2NT: Not tested

Lin 0.5

Van 2

0.5

2

2

4

1

1

1

4

4

4

NT2

1

The antibacterial evaluation was then broadened to include eight additional Gram-positive strains including Staphylococcus epidermidis, vancomycin-resistant enterococci (VRE), Listeria monocytogenes, Clostridium difficile, and cephalosporin-resistant Streptococcus pneumoniae. The eight tested phenylpyrazoles exhibited potent antibacterial activity against the tested Grampositive pathogens, inhibiting growth of the tested strains at concentrations ranging from 0.5 to 4 µg/mL (Table 3). The antibacterial activity of the cyclopentyl-containing derivative 23 outperformed both frontline therapeutics (vancomycin and linezolid), especially against VRE (Enterococcus faecalis and Enterococcus faecium, the two clinically important strains with very limited treatment options).24-28 The high potency of derivative 23 was also observed against MDRS. pneumoniae, a notorious microorganism that is responsible for the vast mortality of lobar pneumonia.29, 30 Moreover, compound 23 was as effective as linezolid and vancomycin against S. epidermidis. S. epidermidis possesses the ability to form strong adherent biofilms on indwelling catheters and implanted medical devices causing a wide range of nosocomial infections, cardiovascular infections, and eye, ear, nose and throat infections.31, 32. Additionally, compound 23 retained the same activity against another clinically important pathogen, Listeria monocytogenes. The latter is a foodborne pathogen that infect humans and animals and can lead to serious, often fatal central nervous system (CNS) infections (listeriosis). Its infections are mostly



found among pregnant women, newborns, and immunocompromised patients.33, 34 It is usually ranked as the third or fourth most common cause of bacterial meningitis in North America and Western Europe.35 Again, the MBC values for all compounds were found to be less than 3-fold higher than their corresponding MIC values against the tested bacterial strains indicating the compounds are bactericidal (Table 3S).


Page 12 of 49

Page 13 of 49 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60


Table 4. Antimicrobial activity of phenylpyrazoles (MICs in µg/mL) against Gram-negative bacterial pathogens Bacterial Strains Compounds/ Control antibiotics 16

18

21

22

23

26

30

35

Gen

8

4

4

4

4

4

8

16

16

8

4

4

4

4

8

>128

16

4

8

4

4

4

4

16

>128

16

0.5

16

8

8

8

8

16

>128

16

64

8

8

8

4

4

8

>128

8

>64

8

8

4

8

8

8

>128

64

0.5

8

8

4

4

4

8

>128

32

1

8

8

4

8

4

16

>128

16

1

16

16

8

8

8

32

>128

64

0.5

16

8

8

8

8

16

>128

32

1

8

8

8

8

4

8

>128

32

8

16

16

16

8

8

16

>128

64

16

16

8

8

8

8

16

>128

32

1

16

8

16

8

4

32

>128

32

1

16

16

32

16

8

32

>128

32

1

16

8

8

8

8

64

>128

64

1

Shigella flexeneri ATCC 9199

16

8

8

8

8

16

>128

32

1

Pseudomonas aeruginosa ATCC 9027

32

16

16

16

16

32

>128

32

0.5


16

32

64

32

16

32

>128

64

0.5


16

32

32

32

32

64

>128

64

2

Acinetobacter baumannii ATCC 19606 Acinetobacter baumannii ATCC BAA 1141 Acinetobacter baumannii ATCC BAA 1747 Acinetobacter baumannii NR 17786 Acinetobacter baumannii NR 17785 Escherichia coli BW251131 Escherichia coli ATCC 25922 Escherichia coli ATCC 35150 Escherichia coli ATCC 1411 Enterobacter cloacae subsp. cloacae ATCC BAA-1143 Klebsiella pneumoniae BAA-1706 Klebsiella pneumoniae BAA-1144 Salmonella enterica NR-170 Salmonella enteritidis ATCC 13076 Salmonella enteritidis ATCC 14028 Salmonella typhimurium ATCC 700720

Gen: Gentamicin

After confirming the activity against multiple Gram-positive pathogens, we moved next to expand our understanding of the effect of the newly developed phenylpyrazoles against Gram-



negative clinical isolates. Table 1 provided some primitive information about the anti-Gramnegative activity as tested against TolC mutant E. coli. To precisely evaluate the activity of the phenylpyrazoles against Gram-negative pathogens, 20 clinical isolates belonging to different families of MDR-Gram-negative species were tested and the results are summarized in Table 4. With the exception of the heptynyl derivative 30, the phenylpyrazoles exhibited reasonable antibacterial activity against Gram-negative pathogens, inhibiting the growth of the tested strains at concentrations as low as 4 µg/mL. The limited activity of compound 30 could be due to the effect of efflux pumps present in these Gram-negative bacterial cells as it showed potent activity against the TolC mutant E. coli, which lacks the efflux pump. Notably, compounds 22 and 23 exhibited the highest activity of all the synthesized derivatives against the highly pathogenic Gramnegative bacteria. Most importantly, compounds 22 and 23 retained their activity against the bacterial strains that showed high resistance to gentamicin, one of the most potent antibiotics used for the treatment of Gram-negative bacterial infections, such as K. pneumoniae ATCC BAA 1144, A. baumannii ATCC 19606, A. baumannii NR 17785 and A. baumannii NR 17786. It is worth mentioning that the corresponding phenylthiazoles structures to 22 and 23 (compounds IS and IIS; Table 1S) did not have any anti-Gram-negative activity (Table 1S). The MBC values for all compounds were found to be equal to or one-fold higher than the compounds’ MIC values against the tested bacterial strains indicating the compounds might have bactericidal activity (Table 3S). To test whether the anti-Gram-negative activity can be maintained against the biggest threat pathogens, such as carbapenem-resistant Enterobacteriaceae (CRE), we screened a panel of CRE in addition to MDR Acinetobacter and Pseudomonas clinical isolates. The selected strains of Gram-negative bacteria have become resistant to nearly all available antibiotics. According to the


Page 14 of 49

Page 15 of 49 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60


Centers for Disease Control and Prevention (CDC), CRE is an urgent public health threat that requires immediate and aggressive action. Each year, infections caused by carbapenem-resistant Klebsiella and carbapenem-resistant E. coli result in approximately 600 deaths. Additionally, nearly

63% of Acinetobacter are multidrug-resistant strains, including resistance to carbapenem, leading to approximately 500 deaths annually in USA. Moreover, MDR Pseudomonas (including carbapenem resistant) infections in USA alone leads to approximately 400 deaths per year.

35-40

Consequently, there is an unmet urgent need for new drugs for the treatment of infections caused by carbapenem-resistant pathogens. In this context, we assessed the activity of phenylpyrazoles against carbapenem-resistant pathogens. The strains listed in Table 5 are classified as multidrugresistant (MDR) strains. The results of the assessment of our newly synthesized phenylpyrazoles against these pathogens can be considered highly promising. For instance, Acinetobacter baumannii ATCC BAA-1605, isolated from a military personnel returning from Afghanistan, is resistant to most antibiotics used for treatment, including ceftazidime, gentamicin, ticarcillin, piperacillin, aztreonam, cefepime, ciprofloxacin, imipenem, and meropemem.41 Klebsiella pneumoniae ATCC 1705 is resistant to as many as 36 representative antibiotics in a variety of drug classes,

including

carbepenems,

β-lactams,

cephalosporins,

quinolones,

tetracyclines,

glycylcyclines, and aminoglycosides. The same resistance pattern was also reported in the cases of Klebsiella pneumoniae ATCC 2146 and Pseudomonas aeruginosa ATCC 1744.42-45 E. coli ATCC 2469 and ATCC 2452 are reported to be New Delhi metallo-beta-lactamase (NDM-1) positive and carbapenems-resistant.46-48 In this regard, compounds 22 and 23 exhibited the highest activity against the tested carbapenem-resistant strains. Both compounds inhibited 90% of the tested strains at a concentration of 16 µg/mL (one-fold lower than MIC90 of tigecycline). In conclusion,



Page 16 of 49

phenylpyrazoles could serve as excellent starting compounds for developing effective therapeutics for the treatment of carbapenem-resistant Enterobacteriaceae (CRE), carbapenemase-producing Acinetobacter and Pseudomonas. Moreover, the MBC values for all compounds were found to be equal to or one-fold higher than the compounds’ MIC values against the tested bacterial strains, indicating the compounds have bactericidal activity against these carbapenem-resistant bacteria (Table 3S). Table 5. Antimicrobial activity (MICs, in µg/mL) of phenylpyrazoles against carbapenem resistant Gram-negative bacterial pathogens including Acinetobacter baumannii, Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa. Bacterial Strains Compounds/ Control antibiotics Escherichia coli ATCC BAA-2452 Escherichia coli ATCC BAA-2469 Klebsiella pneumoniae ATTC BAA-1705 Klebsiella pneumoniae ATTC BAA-2146 Acinetobacter baumannii ATCC BAA 1605 Pseudomonas aeruginosa ATCC 1744 MIC90

16

18

21

22

23

26

35

Imp

Mer

Tig

Col

32

16

8

8

4

64

16

32

32

0.25

0.06

32

8

4

8

4

64

32

32

32

0.5

0.06

16

16

8

16

8

64

64

32

32

1

0.125

32

32

8

16

16

>64

64

32

64

4

0.25

16

8

4

4

8

32

16

32

32

1

0.25

32

32

32

16

16

64

32

16

16

8

1

32

32

32

16

16

>64

64

32

64

8

1

Imp: Imipenem Mer: Meropenem Tig: Tigecycline Col: Colistin MIC90: The concentration which inhibited 90% of the tested strains

Apart from the direct inhibitory activity on bacterial cells, modern antibiotics should possess additional attributes to be efficient in clearing bacterial pathogens. For instance, the ability of a microorganism to build a biofilm mass creates a hardly surmountable shield for traditional antibiotics.49, 50 For instance, up to a 1,000 fold higher than MIC concentration of antitbiotics is


Page 17 of 49 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60


needed to clear a biofilm. Therefore, many frontline antibiotics, such as teicoplanin and vancomycin, were excluded from the clinically useful lists for treating bacterial biofilm.51 In this regard, all active compounds from the panel of newly synthesized phenylpyrazoles were tested for their ability to inhibit biofilm formation against MRSA USA300. The strain MRSA NRS 384 (MRSA300) was selected for this assay based on its biofilm consistency after screening a panel of MDR-biofilm-producing staphylococcal strains (Figure 2S). As seen in Figure 2, all active compounds were superior to vancomycin in their ability to inhibit biofilm formation. At 0.5×MIC, vancomycin inhibited 18% of MRSA biofilm formation. Phenylpyrazoles with linear, aromatic and branched side chains (compounds 16, 22, and 36) exhibited the highest biofilm inhibition activity. At a non-toxic, very low concentration (0.5×MIC), compounds 16, 22 and 36 significantly inhibited 74%, 50% and 62% of MRSA300 biofilm formation, respectively. This is many fold superior over the cornerstone therapeutic vancomycin. On the other hand, the most promising antibacterial candidate in this series in terms of MIC values (compound 23) was relatively less potent in term of biofilm-mass reduction, as it significantly inhibited MRSA300 in a biofilm by only 31% at 0.5×MIC concentration, which is almost two-times significantly higher than the reference drug vancomycin. Compound 21 was non-significantly higher than vancomycin in inhibiting MRSA300 biofilm formation, where it inhibited approximately 22% of its biofilm formation at the tested concentration (0.5×MIC).



Figure 2. Investigation of the antibiofilm activity of phenylpyrazoles against MRSA USA300. Data are presented as percent inhibition of MRSA USA300 biofilm formation. DMSO (the solvent for tested compounds) served as a negative control and vancomycin served as the control antibiotic. The values represent an average of quadruplicates of each compound/drug. Error bars represent standard deviation values. An asterisk (*) denotes statistical significance (P < 0.05) between results for the tested compounds and the control antibiotic (vancomycin) analyzed via unpaired Student’s t-test. Next, we moved to investigate the ability of our newly synthesized compounds to clear microorganisms harbored intracellularly inside infected macrophages. For the effective management of intracellular bacterial infections, there is a critical need for new types of antimicrobials that will treat persistent and MDR-intracellular bacterial infections.


Page 18 of 49

Page 19 of 49 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60


Figure 3. Activity of compounds 23 and 35 on the clearance of intracellular MRSA USA400 present in murine macrophage (J774) cells. Data are presented as percent reduction of MRSA USA400 colony forming units inside infected murine macrophage cells after treatment with 2×MIC of compounds 23 and 35 (tested in triplicate) for 24 hours. Data were analyzed via a unpaired Student's t-test (P < 0.05). Asterisks (*) represent a significant difference between the treatment of J774 cells with compounds 23 and 35 in comparison to vancomycin. First, we assessed the ability of compounds 23 and 35 to clear intracellular MRSA inside the infected macrophages. Compound 23 was capable of reducing the intracellular MRSA by 1.01 log10-reduction, which is equivalent to 90% reduction of intracellular MRSA, at 2×MIC, while its imidazoline analog 35 reduced the intracellular MRSA400 by 1.79 log10-reduction. This is equivalent to approximately 98.4% reduction of intracellular MRSA at the same tested concentration (2×MIC) (Figure 3). On the other hand, vancomycin, given its high molecular weight and complex structure, was not able to sufficiently accumulate inside macrophage cells and clear intracellular MRSA infections, as expected.52,

53

In agreement with the previous reports,

vancomycin did not reduce the presence of MRSA inside infected J774 cells after 24 hours of treatment. These results collectively indicated that this class of newly discovered phenylpyrazoles



could pass into the infected macrophage cells, even at a lower concentration (2×MIC), and significantly reduce the burden of MRSA inside them.

Figure 4. Examination of the activity of compounds 22 and 23 on the clearance of intracellular Salmonella enteritidis ATCC 14028 present in murine macrophage (J774) cells. Data are presented as percent reduction of Salmonella enteritidis colony forming units inside infected murine macrophage cells after treatment with 2×MIC of compounds 22 and 23 (tested in triplicates) for 24-hours. Data were analyzed via an unpaired Student's t-test (P < 0.05). Asterisks (*) represent a significant difference between the treatment of J774 cells with compounds 23 and 35 in comparison to vancomycin.

After confirming the ability of phenylpyrazoles to clear the intracellular Gram-positive bacterial cells, we moved to determine whether the potential therapeutic application of phenylpyrazoles could be expanded beyond merely inhibiting Gram-negative bacteria. Their ability to clear the intracellular Gram-negative pathogen Salmonella enteritidis harbored inside infected macrophages was evaluated (Figure 4). In this case, two of the most promising derivatives against Gram-negative bacteria were chosen; compounds, 22 and 23. The phenylpyrazole 23 was capable of significantly reducing the intracellular Salmonella enteritidis by 1.76 log10, which is


Page 20 of 49

Page 21 of 49 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60


equivalent to a 98% reduction, at 2×MIC. Additionally, compound 22 significantly reduced the burden of intracellular Salmonella enteritidis by 0.57 log10, which is equivalent to a 70% reduction, at 2×MIC. These results collectively indicated that the phenylpyrazoles could gain entry and accumulate inside infected macrophages and significantly reduce the burden of intracellular Salmonella. On the other hand, kanamycin, an efficient anti-Gram negative antibiotic, at 2×MIC (16 µg/mL), as reported earlier54, was unable to sufficiently accumulate inside infected macrophages and thus was unable to clear the intracellular Salmonella (Figure 4).

Figure 5. Multi-step resistance study of compounds 22, 23, 35 and rifampicin against methicillin-resistant S. aureus USA400. Bacteria were serially passaged over a 14-days period, and the broth microdilution assay was used to determine the MIC of each compound/control antibiotic against MRSA USA400 after each successive passage. A four-fold increase in MIC would be indicative of bacterial resistance to the test agent.

Finally, to investigate whether the pathogenic microorganisms are able to develop rapid resistance to this newly introduced class of antibacterial agents, a multi-step resistance study was conducted for the three most promising compounds 22, 23 and 35 against MRSA USA123 (MRSA400). As shown in Figure 5, the MIC values of 23 remained stable along the 14-passages without any increase. On the other hand, the MIC values for 22 increased by one-fold after the



tenth passage and remained stable after that. The MIC values of the corresponding imidazoline 35 increased by 2-folds after 14-passages (one-fold increase in the eighth passage and another onefold increase on the fourteenth passage). In contrast, MRSA USA400 developed resistance rapidly to the antibiotic rifampicin, in agreement with previous reports.55, 56 The MIC of the antibiotic increased 7-folds after only one passage and continued to increase rapidly (>500,000-fold increase in MIC by the thirteenth passage). The results indicate that MRSA was unable to develop a rapid resistance to any of the tested phenylpyrazoles and can rapidly develop resistance to rifampicin (Figure 5). Pharmacokinetic evaluation. The metabolic stability and rate of clearance of the phenylpyrazoles compounds 23 and 35 were initially investigated using in vitro assays (Table 6). The most promising derivative in this series, compound 23, showed a high degree of metabolic stability with an intrinsic half-life (t1/2) of more than 3 hours. This value was increased in the absence of NADPH, the co-factor of CYP-450, indicating that the phenylpyrazole 23 is mainly metabolized by this class of metabolic oxidases. The imidazoline analog compound 35 showed similar high metabolic stability in the presence of NADPH, but the half-life value was significantly increased when measured in the absence of NADPH, suggesting compound 35 is an exclusive substrate for CYP-450. Furthermore, unlike some reported phenylthiazoles that were found to be substrates for the efflux system, the Caco-2 assay for compounds 23 and 35 indicated that our newly discovered phenylpyrazoles are not substrates for P-gp efflux pumps. Unfortunately, both tested phenylpyrazoles possess very limited permeation properties (Table 7), which means that they are not suitable for the oral route. Finally, the metabolic stability of this novel class of antibacterial compounds was further confirmed by measuring the biological half-life in rats, in which compound


Page 22 of 49

Page 23 of 49 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60


23 showed a biological half-life of 10.5 hours (Figure 6). This value roughly suggests a once-daily dosing regimen after parenteral administration. Table 6. In vitro preliminary pharmacokinetic parameters; half-life and intrinsic clearance (T1/2 and Clint) of compounds 23 and 35. Compound

Incubation Time (min)

% Compound Remaining Half-Life (min) 1st 2nd Mean 1st 2nd

23

0

100.0

100.0

100

23

15

92.1

93.6

93

23

30

95.0

88.9

92

23

45

80.2

82.1

81

23

60

81.4

82.1

82

23 (no NADPH)

0

100.0

100.0

100

23 (no NADPH)

15

98.9

99.1

99

23 (no NADPH)

30

98.0

99.0

99

23 (no NADPH)

45

{85.3}

98.9

99

23 (no NADPH)

60

90.7

91.6

91

35

0

100.0

100.0

100

35

15

103.6

93.7

99

35

30

99.5

84.3

92

35

45

83.7

75.2

79

35

60

80.5

78.0

79

35 (no NADPH)

0

100.0

100.0

100

35 (no NADPH)

15

97.4

99.1

98

35 (no NADPH)

30

96.5

96.6

97

35 (no NADPH)

45

96.5

{100.0} 97

35 (no NADPH)

60

96.5

96.6

Mean

Clint (µL/min/mg)

188.8

198.1

194

35.8

418.4

591.7

505

From Phenylthiazoles to Phenylpyrazoles: Broadening the

Recommend Documents